Predicting the histologic dating of an endometrial biopsy specimen with the use of Doppler ultrasonography and hormone measurements in patients undergoing spontaneous ovulatory cycles

Objective: To examine the relation between uterine blood flow and endometri al thickness on transvaginal Doppler ultrasonography, serum E-2 and progest erone levels, and the histologic dating of an endometrial biopsy specimen o btained in the midluteal phase of a spontaneous cycle. Design: Prospective clinical study. Setting: A tertiary care infertility center. Patient(s): One hundred fifty-nine patients with normal menstrual cycles. Intervention(s): Transvaginal Doppler ultrasonographic evaluation of uterin e blood how and endometrial thickness, determination of serum concentration s of E-2 and progesterone, and endometrial biopsy. Main Outcome Measure(s): Resistance index, pulsatility index, serum E-2 and progesterone levels, endometrial thickness, and histologic dating of the endometrium. Result(s): One hundred thirteen (71%) of the endometrial biopsy specimens s howed complete secretory transformation and thus were classified as "in pha se," and 46 (29%) of the specimens lacked some or all of the criteria for s ecretory transformation and thus were classified as "out of phase." There w as no statistically significant difference between the in phase and out of phase groups with regard to patient age, endometrial thickness, serum hormo ne levels, or resistance index. The pulsatility index was significantly hig her in the in phase group. The overall predictive value of the studied para meters was only 64% (sensitivity, 57%; specificity, 66%). Conclusion(s): Doppler ultrasonographic evaluation of uterine blood dow and measurement of hormone concentrations cannot be used to predict the histol ogic dating of an endometrial biopsy specimen obtained in the midluteal pha se of a spontaneous cycle. (Fertil Steril(R) 2000;73:94-8. (C) 1999 by Amer ican Society for Reproductive Medicine.)